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x C'�] <br />[n" � H <br />9 H tn <br />�z� <br />o zo <br />� fA H <br />�o� <br />o� <br />��g <br />n. � <br />r r+ y <br />g�' <br />H <br />!� O � <br />3�r <br />z y vi <br />H O fn <br />0 ~ �� <br />..� ,� <br />APPLI�ATiON FOR COPISii�lf�'ii.e1�B 0"EF%'�1IIiT � <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />rn„6< < <br />CITY OI�:��,� <br />everett I HEATINGSYSTEM JGAS �IELECTRIC J__-- --� <br />BUILDING DEPARTMENT <br />259-8810 <br />D[MOLITION COMBINATIO� BUILDING MECHANICAL �PLUMBING SIGN <br />� _� . __ . . �_ pn�lADDFCSS ('�v .6 Pi.J4f <br />�_}�oy_ �oRiDl� �B�J.U�ecJl�h_� 9�ao3— <br />I!!L•.1 <br />Vll. M1CJ��f SS fllv PIIONE <br />PNOqE <br />. __.--. .- — _ <br />___ — <br />._ _ — --" _ _ . _ .;. r ,eC uCENSE � <br />'.I�rt::O�t -.�_ .cC: .�, .� <br />J�mU,ssc�ier y7ogcv.v,e..u�1: Ec�reff 982a3-- -�?"3—� �,._,.,�. - <br />. ,.,. . . . :.� 3� <br />-- <br />-- — — <br />,^� - �,� r,�,:.'.. ti: -_____ .. _ . . . ...E uCE�:SC� <br />R�2T's VzctmBl�,.TK�1oa__�4Qe"D'�, Sib�io �`-���0-5�8-_i237__�_RbP_I *1Q38�- <br />��r;_�y�� nGDlTiqd ALiE�aAiiON REPAi:i DE1.10LI1IDN WOODSIOVEFRPI.INSERT BUILDINGRELOCATiCPo <br />_ .. . _ _ _ _ _ . . . _ _ _ _ — — —_ <br />� —_—__ —_ - .��'n._tr[u5bvm�ur.�o`..rio <br />:, �9a5:� <br />-. -� "��E�� � <br />;,� , '/ <br />%�mm f�al�, tioa _ _ <br />� �tii E i n�•y I HEAEBY CEFTIFV THAT I HAVE READ AND EXAMWED 111i5 <br />M�� {[ �[ / 4PPLICATION AND KNOW THE SAMe TO BE TRUE AN� CORRECT l.LL <br />� � — � PROVISIUNS OF lAWS AND ORDMANCES GOVERNING THIS TVP[ OF <br />/ i /J.Lon <br />.•�SCNivtiLVO:��•�.:1��.�. . ... �Ufi9�Ti�GM[OURLOPIES� <br />WORK WILL BE COMPLETED WITH WHETNER SPECIFIED HEREIN OH <br />r�-.. � c� NOT. THE GRANTING Of- A PER6IIT DOES NOT PRESUM[ TO GIVC. <br />� F A�Jv <br />�/aS 1J. U; e�v�0-, � �i,�j�71 S'S�o3 <br />RE OR ITEM <br />11 _ _ __.—____ <br />SH(1WER <br />KIT( �HEN SINK e DI! <br />DISF WASH[R <br />LAU�iDRV TRAV <br />CIOTHES WASHER <br />URINAL <br />f3l[i �7:7 <br />:TiZ�7� <br />FOR OFFICE USE ONLY: <br />... l`�f�HA/,N � HI_Ffi`. <br />. ; u. � � I OT �RER <br />,� �.�-�ONiS�LLOW4BlE � tYi'EOf <br />:��:ALDG I NO.Of <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O <br />OTHER SiATE OFl LOCAL UW REGULATItJG CONSTRUCTIO'J OP7 TNE <br />PERFOAMANCE OF CONSTRUCTION, THAT i AM AUTHOf71ZED 8� THE <br />OWNER OF TNIS PROPERTY TO PERFORId THE WORK FOH WNICH <br />APPUCATION IS MADE ANO I COIdPLV VJRH THE STATE <br />��1NTfinC10RS Lf�W 1827 RCW AM1D 296 200 WAC <br />..,. �n.rioaCuiaom.�:;;�ne-�c•,- ;'n�� �%.5(/9� <br />X �,vsP�n�`�z33� <br />�, �,2r's l�amB�,�C,,,,� . :. _- <br />E NO. TVPE OP EOUIPMENT <br />.� pr qHNDLGUN175--N.P. <br />� FORCEDAIRS:'STEMS—B.T.U. M E.A. <br />r� _ UMT HEATEFS—B i.LL M <br />� CLOTHES �RVERS <br />�.C� <br />VENTILATION FAN <br />RANGEHOOD <br />� WATER HEATER <br />- WOOD S70VE <br />METAL FIREPLACE 8 CHIMNEY <br />� FIREPLACEINSERT <br />HEAT PUMP <br />, GAS PIPING <br />SUBTOTAL 5 _ /5;G17 __ <br />PERMIT S / <br />p��_ _ <br />TO7ALFEC- $ — % 7 � <br />510[ SL111�1K <br />�UIL�ING <br />MNCU1fY NOUVMWM4lM'15 —"--- <br />''"a'' PLUMOING <br />PASFMEHT MECHANICAL <br />r�FIGHI utArtntlIXl A�OITIONAL PLAN CHECK <br />OTHER <br />S1nTE OUILDING SURGHARGE <br />.., ,,� vunsA�rno��eox� -'I CITY OF EU[RETT Pl1fiL�G WORKS <br />�— LOCRL SIILES <br />I�X CODF IS 3105 ���r^�� _ <br />SUB TOTAL a _ <br />PERMIT 5 <br />TOTALFEE 5 <br />RCCCIPi NO. <br />Ve111ATION FEF <br />